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Optical coherence tomography imaging during percutaneous coronary intervention impacts physician decision-making: ILUMIEN I study

Perspective | By Wijns W, Shite J, Jones MR et al.

AIMS - ILUMIEN I is the largest prospective, non-randomized, observational study of percutaneous coronaryintervention (PCI) procedural practice in patients undergoing intra-procedural pre- and post-PCI fractional flow reserve (FFR) and optical coherence tomography (OCT). We report on the impact of OCT on physician decision-making and the association with post-PCI FFR values and early clinical events. ...

Radial Versus Femoral Access for Rotational Atherectomy: A UK Observational Study of 8622 Patients

Original Research | By Watt J, Austin D, Mackay D et al.

BACKGROUND - Rotational atherectomy (RA) is an important interventional tool for heavily calcified coronary lesions. We compared the early clinical outcomes in patients undergoing RA using radial or femoral access. METHODS AND RESULTS - We identified all patients in England and Wales who underwent RA between January 1, 2005, and March 31, 2014. Eight thousand six hundred twenty-two R...

Rotational atherectomy and new-generation drug-eluting stent implantation

Original Research | By Hachinohe D, Kashima Y, Kanno D et al.

OBJECTIVES - The aim of this study was to evaluate the clinical outcomes of rotational atherectomy (RA) followed by new-generation drug-eluting stent (DES) implantation in patients with an extensive amount of calcified and fibrotic plaque. BACKGROUND - RA followed by new-generation DES implantation for complex lesions has not been thoroughly evaluated. METH...

Outcomes after drug-coated balloon treatment for patients with calcified coronary lesions

Clinical Trial | By Ito R, Ueno K, Yoshida T et al.

OBJECTIVES - To investigate the efficacy of drug-coated balloon (DCB) for calcified coronary lesions. BACKGROUND - Calcified coronary lesions is associated with poor clinical outcomes after revascularization. Recently, DCB is emerging as an alternative strategy for de novo coronary lesions. However, reports describing the efficacy of DCB for calcified ...

Sex differences in left main coronary artery stenting: Different characteristics but similar outcomes for women compared with men

Original Research | By Shin ES, Lee CW, Ahn JM et al.

BACKGROUND - The clinical outcomes for women compared with men undergoing left main PCI were sparse. We compared the characteristics and long-term outcomes in women versus men after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for unprotected left main CAD. METHODS - We identified 2328 patients (545 women; 1783 men) with unprotected left main CAD who received PCI wi...

Prognostic significance of QRS fragmentation and correlation with infarct size in patients with anterior ST-segment elevation myocardial infarction treated with percutaneous coronary intervention: Insights from the INFUSE-AMI trial

Clinical Trial | By Redfors B, Kosmidou I, Stone GW et al.

BACKGROUND - QRS fragmentation (fQRS) is believed to reflect myocardial scar formation in patients with coronary disease. Whether early formation of fQRS in patients with ST-segment elevation myocardial infarction(STEMI) treated with percutaneous coronary intervention (PCI) is correlated with infarct size and prognosis is unknown. We assessed the prognostic value of fQRS at 60min post-PCI and its cor...

Causes of delay and associated mortality in patients transferred with ST-segment-elevation myocardial infarction

Perspective | By Miedema MD, Newell MC, Duval S et al.

BACKGROUND - Regional ST-segment-elevation myocardial infarction systems are being developed to improve timely access to primary percutaneous coronary intervention (PCI). System delays may diminish the mortality benefit achieved with primary PCI in ST-segment-elevation myocardial infarction patients, but the specific reasons for and clinical impact of delays in patients transferred for PCI are unknown. ...

Symptom onset-to-balloon time and mortality in the first seven years after STEMI treated with primary percutaneous coronary intervention

Perspective | By Rollando D, Puggioni E, Robotti S et al.

OBJECTIVE - To evaluate the consequence of treatment delay of primary percutaneous coronary intervention (PPCI) on long-term survival. BACKGROUND - Network organisation based on early recognition, shortening prehospital time delays and procedural delays is the cornerstone of optimal clinical results in the acute phase of ST-segment elevation myocardial infarction (STEMI). Nevertheless, the ...

Outcome of patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention during on- versus off-hours (a Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction [HORIZONS-AMI] trial substudy)

Original Research | By Cubeddu RJ, Palacios IF, Blankenship JC et al.

Patients with ST-segment elevation myocardial infarction (STEMI) admitted during nonregular working hours (off-hours) have been reported to have greater mortality than those admitted during regular working hours (on-hours), perhaps because of the lower availability of catheterization laboratory services and longer door-to-balloon times. This might not be the case, however, for hospital centers in which primary percutaneous coronary intervention (PCI...

Nonsystem reasons for delay in door-to-balloon time and associated in-hospital mortality: a report from the National Cardiovascular Data Registry

Original Research | By Swaminathan RV, Wang TY, Kaltenbach LA et al.

OBJECTIVES- The goal of this study was to characterize nonsystem reasons for delay in door-to-balloon time (D2BT) and the impact on in-hospital mortality. BACKGROUND - Studies have evaluated predictors of delay in D2BT, highlighting system-related issues and patient demographic characteristics. Limited data exist, however, for nonsystem reasons for delay in D2BT. METHODS&n...

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